feature: good health
Working towards w
Stress and depression can affect
people in many ways – but a
new provision is helping people
to work through their problems
and get back to work
I
f you’ve ever been affected by depression,
anxiety or stress, you’ll know that it can be a
vicious circle. The more you worry about the
issues that are affecting you, the more stressed,
anxious and depressed you become. And the only
way out is to break that circle, which is not always as
easy as it seems.
Being depressed or highly stressed can affect
all areas of your life, especially in relation to work.
Many people have to leave their jobs as the feel
that they can’t cope, which can then lead to further
depression as they feel they have nothing to get up
for in the morning.
However, an innovative new scheme provided
by A4e has has been helping people affected by
depression, anxiety and stress to return to work. The
approach is based on Cognitive Behaviour Therapy
(CBT) and delivered by the Occupational Support
Service, headed up by psychologist Dr William Fear.
Stress can greatly affect your
working life and job prospects.
26 blueprint summer 2009
A4eSum09 pp26-27 Wellbeing.indd 26
The service was started in the Pathways to Work
programme, and has been expanded for use within
A4e and other occupational health-related services.
According to Dr Fear, it’s a very innovative
provision. ‘It’s not the same old condition
management programme that people are used to,’
he says. ‘We have developed a provision that helps
people return to work, whether they are on benefits
or sickness absence.
‘In the past, people thought you needed to do
something different for each group of people who
were out of work. But we’ve found that our service
works equally well for all groups.’
A4e’s CBT-based provision was first developed
and used by Dr Fear’s team in Wales. Realising
that something different was needed to encourage
people back to work, Dr Fear and his team carried
out extensive in-house research to develop the
approach. Based on a number of existing methods
including CBT, Motivational Interviewing and
We have
Solution-Focused Brief Therapy, the focus of the developed a
research was to find a way of helping people to
overcome ‘health related barriers to work’ and to
provision that
‘realise their full capabilities’. helps people
So how does the Occupational Support Service
help people? ‘It’s very much concerned with return to work,
people’s beliefs and capabilities,’ says Dr Fear. ‘We whether they
assess what people can do, not what they can’t do.
We help them see where their strengths are, and are on benefits
encourage them to think differently.
‘I think having a strong ethos also helps. We
or sickness
understand that work is a form of treatment, and absence
that people sometimes need support to develop
Dr William Fear
ways of managing, or coping, with difficult
situations. We give them the tools to do that.’
Back on track
Janie (not her real name) had been on Incapacity
Benefit for eight years. She had been diagnosed with
depression and was taking prescribed medication.
Janie joined Pathways as a client, and opted to take
part in the Occupational Support Service. Just one
month later, Janie was working full-time, and 14
months on, she has a flawless sickness absence
record, a strong track record of performance, and
has regained her professional registration.
‘I didn’t think I would ever work again’, says Janie.
‘Things were really difficult. I’d been out of work for
so long, and I was smoking and taking a high dose
of antidepressants. I had also lost my professional
14/5/09 15:20:00
 feature: good health

s wellbeing registration, which meant I couldn’t work in my

chosen field. It was horrible.’
So what was it that made the difference?
‘Someone gave me hope,’ she says, ‘and showed me
how to cope. I’m now working full-time and I love
what I do. I don’t smoke, I eat properly, and I don’t
take any medication – and I haven’t taken any since
I started work.
‘The Occupational Support Service has changed my
life. The biggest reward for me has been the way I have
been able to share this with my family and friends.’
FAST FACTS
Janie has been able to put her occupational skills
to good use, thanks to her time on the programme.
The service has four
‘I now work with Dr Fear in the Occupational
distinct elements to it:
Support Service, helping people to get back to l One-to-one interviews
work and to stay in work,’ she explains. ‘We often delivered by trained,
help people who are at risk of long-term sickness qualified professionals.
This includes assessment
absence, not just people who are on benefits and
and the more specialist
want to go back to work.’ CBT-related interventions.
She adds: ‘The approach is so different to the way l Health and wellbeing

I was treated when I was on benefits. It really works groups. These groups
look at changing health-
and it makes such a difference to people.’
related behaviour, from
adopting healthy lifestyles
Valued support through to coping with
‘We’ve been lucky,’ explains Dr Fear. ‘A4e depression, anxiety,
stress, and pain.
understands the value of our Occupational Support l The Directions
Service and what we do. We’ve been encouraged groups.This is a unique
to be innovative, and we’ve been supported in motivational and
the development of the service. Everything we do confidence-building
workshop based on
is carefully evaluated and we work within strong the ‘five areas’ CBT
ethical and governance frameworks. approach.
‘The evidence for our provision is clear from l The JOBS program,
which is an international
our performance on Pathways. In fact, we received
program that builds
public acclaim from the Director of Job Centre Plus confidence in relation
in North Wales for our service.’ to job search skills and
There are plans to expand the service, and Dr entering employment.
Fear’s team is already delivering a Fit for Work
program in line with Dame Carol Black’s Health
and Wellbeing strategy. ‘What we have,’ he says,
‘is something that can help with worklessness,
whether that be as a result of being completely out
of work and on benefits, or as a result of long-term
sickness absence. In the end, the consequences of
worklessness are always the same. Our aim is to
eradicate worklessness completely.
‘The outstanding success of our Occupational
Support Service is down to having a fantastic
team and the support we have received from A4e.
At the end of the day it’s real people who benefit in
a real way.’

blueprint summer 2009 27

A4eSum09 pp26-27 Wellbeing.indd 27 14/5/09 15:20:07